=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770266892
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NEXT LEVEL PHYSICAL THERAPY AND SPORTS PERFORMANCE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/08/2023
-----------------------------------------------------
Last Update Date | 01/21/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 CLARENDON LN
-----------------------------------------------------
City | BLUFFTON
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29909-3112
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-937-3188
-----------------------------------------------------
Fax | 843-604-0269
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 CLARENDON LN
-----------------------------------------------------
City | BLUFFTON
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29909-3112
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-937-3188
-----------------------------------------------------
Fax | 843-604-0269
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | CHRISTOPHER A MARTINELLI
-----------------------------------------------------
Credential | DPT
-----------------------------------------------------
Telephone | 814-937-3188
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------